| Objectives: This study compared the efficacy,safety and long-term survival of CDOP-like regimen and CEOP-like regimens for the treatment of DLBCL.Methods: 159 patients with untreated DLBCL at Tianjin Medical University Cancer Institute and Hospital and Department of Oncology,Tianjin Union Medicine Centerfrom January 1,2011 to June 1,2015 were retrospectively analysed.According to the strategies whether contained liposomal adriamycin or not,patients were divided into group A(CDOP-like regimen,52 cases)and group B(CEOP-like regimen,107 cases).The efficacy,safety and survival of the two groups were compared.Results: 1.The clinical features: the median age of 159 cases was 59 years(22-80),the median agesof the two groups were 59 years old and 58 years old,respectively;Ann-Arbor stage ?-? was 48.1% and 56.1% respectively.GCB accounted for 38.5% and 51.4%,respectively.The percentages of IPI score>2 points were 50.0% and 57.0% respectively.Patients with cardiovascular disease accounted for 25% and 20.6%,respectively.The difference of clinic features in the two groups were not statistically significant(P>0.05).2.The ORR of group A was higher than that of group B(80.8%vs 75.7%),but P value >0.05;The ORR of group A was higher than that of group B in both early(?/?)and late(?/?)stage patients,but there was no statistical difference(P>0.05).There was no significant difference in the rate of objective response between the IPI ?2 group and>2 group,whether it contained adriamycin liposomes.Similar results were observed in older and younger patients.3.With a median follow up of 43 months,estimated 3-year and 5-year PFS in 159 cases was 60.2% and 49.9%.Estimated 3-year and 5-year OS was 78.4%,60.3%.Estimated 3-year PFS in two groups was 64.9%,58.1% respectively,and 3-year OS 86.4%,74.3% respectively.There was no statistical difference(P=0.248 and P=0.054).4.Hand and foot syndrome(HFS)only appeared in group A.The incidence of cardiotoxicity,hematologic,bladness,nausea and vomiting in group B was significantly higher than that in group A(P < 0.05).The incidence of fever,thrombocytopenia,anemia,diarrhea,abnormal liver function,neurotoxicity and fatigue was similar in both groups.A total of 30 cases had heart toxicity-related events.The incidence of cardiotoxicity in group A(9.6%)was lower than that in group B(23.4%).There was no symptomatic cardiotoxicity in group A.Cardiotoxicity in group A included the new ST-T change(3 cases),incomplete right bundle branch block with LVEF decreased(1 case),accidental premature beat(1 case).Among them,two patients with previous history of angina pectoris.There were 25 cases with abnormal electrocardiogram in group B,including LVEF decreased 5 cases.5 cases presented symptomatic cardiotoxicity,including 2 cases of congestive heart failure,1 case of angina pectoris,1 cases of sinus tachycardia,1 case of atrial fibrillation.Among them,there were 2 cases with previous hypertension and 1case with angina pectoris.The incidence of cardiotoxicity of elderly patients in group A was lower than that in group B(11.5% vs 37.5%,P = 0.029).The incidence of cardiotoxicity of young patients in two groups was similar(7.7% vs 11.9%,P = 0.715).5.Multivariate analysis showed age and IPI score were independent poor prognostic factors for all patients.Conclusions: 1.The efficacy of CDOP-like regimen is similar to that of CEOP-like regimens for early treatment of DLBCL,but CDOP-like regimen could reduce adverse effects such as cardiotoxicity,myelosuppression,and bladness.2.CDOP-like regimens is the good treatment option for elderly patients with DLBCL,especially with cardiovascular disease,poor physical condition. |
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